The ringlight in the middle is actually a Vivitar 5000 Macrolight, plugged into the PC port on the camera, while one of the Vivitar 283 flashes is physically connected to the hotshoe, and supported by an Ebay Stroboframe knockoff. The final Vivitar 283 flash is supported by a very cheap Ebay bracket and an Ultramount head, and is triggered by an optical slave, so I wouldn't expect it to work well outside on a sunny day.
The setup does work, but I did it a bit more as an experiment, and it is horribly cumbersome to use; the flashes are heavy, the supports are flimsy and tend to move all over the place, all the flashes save for the ringlight need to be manually adjusted, while the ringlight tends to overexpose because it lacks any sort of manual control. I wasn't able to test the rig on any real "macro-like" subjects because of the 40cm of snow outside, but I'm not confident the setup would survive much bouncing around in my backyard, nevermind a hike through the woods.
As fun as it was to put everything together (and cackle diabolically while doing so), I'll stick to my 430EX plus Vivtar 5000, which, while heavy, is still portable and does the job consistently enough for my needs.
Also, to anyone who is inclined to repeat my mad scientist experiments: Don't use flashes of unknown trigger voltage! In addition to the manual controls, I modified these two Vivitar 283s to 4.5V trigger voltage from over 100V, and checked the Macroflash again and again to make sure the voltage was low enough and safe to use on my 40D. If you don't do this, you run the risk of destroying your camera's electronics!